ADDRESS

By
C, Everett Koop, M.D,
SURGEON GENERAL
U.S, Pupiic HEALTH SERVICE
AND
DEPUTY ASSISTANT SECRETARY FOR HEALTH
U.S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

PRESENTED TO THE SURGEON GENERAL’S WORKSHOP

On PoRNOGRAPHY
June 22, 1986
I

— GGREETINGS TO HOSTS, GUESTS, FRIENDS, ETC.)

I WANT 10 THANK EACH OF YOU FOR ACCEPTING MY INVITATION TO THIS
WORKSHOP, LET ME ASSURE YOU THAT I DID NOT LIGHTLY OFFER THOSE
INVITATIONS, I WAS GIVEN GOOD AND SERIOUS COUNSEL ABOUT THE KINDS OF
PEOPLE WHO OUGHT TO BE INVITED. I ACCEPTED THAT COUNSEL. AND THEN,
WITH ADDITIONAL HELP FROM A NUMBER OF PEOPLE BOTH WITHIN AND OUTSIDE
GOVERNMENT, I CHOSE EACH OF YOU BY NAME.

IT ASKED YOU TO COME TO WASHINGTON THIS WEEK TO HELP ME AND THE
U.S, PUBLIC HEALTH SERVICE ACHIEVE A BETTER UNDERSTANDING OF THE
IMPACT THAT PORNOGRAPHY HAS UPON THE MENTAL AND PHYSICAL HEALTH OF OUR
CITIZENS, ESPECIALLY OUR CHILDREN AND YOUNG PEOPLE,
2

SOME CRITICS HAVE SAID THAT I’VE BEEN RELUCTANTLY PUSHED INTO
THIS EVENT BY THE DEPARTMENT OF JUSTICE. OTHERS. HOWEVER, SEEM TO
THINK I’M PLUNGING INTO THIS QUESTION WITH QUESTIONABLE HASTE.

BOTH ARE WRONG,

THE ISSUE OF PORNOGRAPHY IN AMERICAN LIFE HAS BEEN A PROFESSIONAL
AND PERSONAL CONCERN OF MINE FOR MANY YEARS, BEFORE MY APPOINTMENT AS
SURGEON GENERAL BACK IN 1981 AND CERTAINLY AFTER MY APPOINTMENT.

I BROUGHT THAT CONCERN TO THE JOB.. NOT THE REVERSE.

BUT I WILL BE COMPLETELY CANDID WITH YOU: ALTHOUGH 1’VE BEEN
CONCERNED ABOUT THIS ISSUE FOR MANY YEARS. I DON’T COUNT MYSELF AS ANY
GREAT EXPERT. AS A PRACTICING SURGEON FOR 35 YEARS, 1 DON’T EASILY
COME BY SUCH HUMILITY, SO I HOPE YOU’LL ACCEPT THIS CONFESSION AS
GENUINE.
3

I’M TELLING YOU THIS SO THAT YOU MIGHT UNDERSTAND, FIRST, WHY
I'VE GONE AHEAD WITH THIS EVENT DESPITE CRITICISMS OF EVERY SHADE AND
STRIPE. AND SECOND, WHY I INTEND TO REMAIN THROUGHOUT THIS WORKSHOP TO

LISTEN AND TO LEARN,

IN THAT REGARD, LET ME ADD THIS FURTHER NOTE. WHILE THIS IS A
"SURGEON GENERAL’S WORKSHOP,” I DO NOT WANT THESE PROCEEDINGS TO HAVE
EVEN AN APPEARANCE OF BEING MANIPULATED IN SOME WAY BY ME OR BY ANY
OTHER GOVERNMENT OFFICIAL,

 

HENCE. I ASKED DR. ALBERTO SERRANO TO ASSUME THE CHAIR OF THIS
WORKSHOP AND KEEP IT MOVING ALONG, WE ARE FORTUNATE TO HAVE HIM,
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AS DIRECTOR OF THE PHILADELPHIA CHILD GUIDANCE CENTER, DR,
SERRANO IS FAMILIAR WITH MANY OF THE QUESTIONS TO BE RAISED THIS
EVENING, TOMORROW, AND TUESDAY, AND, AS A RESPECTED PROFESSOR OF
CHILD PSYCHIATRY AT THE UNIVERSITY OF PENNSYLVANIA, HE ALSO RECOGNIZES
YOUR LEADERSHIP IN THIS AREA,

HIS WILL NOT BE AN EASY TASK, YET, I REGARD IT AS IMPORTANT FOR
THE ACCOMPLISHMENT OF OUR OBJECTIVE, WHICH IS, AS I’VE INDICATED, THE
FRAMING OF A CONSENSUS AS TO WHAT WE BELIEVE TO BE PORNOGRAPHY ’S
IMPACT ON PUBLIC HEALTH IN AMERICA,

T HOPE WE WILL ALL GIVE OUR SUPPORT TO DR. SERRANO DURING THESE
THREE DAYS OF WORK,
5

AS 1 SAY, I’VE HAD A LONG-STANDING INTEREST IN THE EFFECTS OF

- PORNOGRAPHY UPON AMERICAN LIFE, HOWEVER, AS I INDICATED IN MY LETTER,
THE IMMEDIATE REASON FOR THIS WORKSHOP GOES BACK ONLY A YEAR -- ALMOST
TO THE DAY -- WHEN I TESTIFIED BEFORE THE ATTORNEY GENERAL'S
COMMISSION ON PORNOGRAPHY,

AT THAT TIME I SAID WHAT I’M SAYING TONIGHT, THAT PORNOGRAPHY HAS
BEEN A SERIOUS CONCERN OF MINE AND I BELIEVED THERE WERE IMPORTANT
PUBLIC HEALTH ASPECTS OF THE ISSUE THAT OUGHT TO BE ADDRESSED,

I VOLUNTEERED TO HELP DEVELOP THOSE DATA FOR THE COMMISSION, IF
ITS MEMBERS SO DESIRED,
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CHAIRMAN HENRY HUDSON AND OTHER COMMISSION MEMBERS TOOK ME UP ON
MY OFFER. BUT THERE WAS A SNAG, CHIEFLY BECAUSE OF THE FUNDING. WHAT
WE HAD ORIGINALLY AND MAYBE UNREALISTICALLY CONCEIVED AS A MAJOR
PUBLIC HEALTH EFFORT HAD TO BE SIGNIFICANTLY REDUCED BOTH IN SCOPE AND
COST, YET STILL BE A THING OF SUBSTANCE,

AFTER SOME DEBATE WITHIN THE PUBLIC HEALTH SERVICE ITSELF, 1
APPROVED THE CONVENING OF THIS “SURGEON GENERAL’S WORKSHOP ON PORNOG-
RAPHY.” ITS PURPOSE WOULD BE TO IDENTIFY SEVERAL KEY POINTS OF
CONSENSUS TO BE REACHED BY SOME OF THE BEST PUBLIC HEALTH AND MEDICAL
TALENT AVAILABLE.

THIS GATHERING, THEN, IS BOTH AN IMMEDIATE RESPONSE TO A REQUEST
BY THE ATTORNEY GENERAL‘’S COMMISSION AS WELL AS A BENCHMARK EVENT FOR
THE PUBLIC HEALTH SERVICE ITSELF,
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I HOPE YOU ARE AS CLEAR ON THIS AS I AM. I’M AWARE THAT THERE
MAY BE SOME QUESTION IN THE MINDS OF A FEW OF YOU AS TO THE IMPORTANCE
OF THIS WORKSHOP, GIVEN THE FACT THAT THE ATTORNEY GENERALS COMMIS-
SION IS EVEN NOW COMPLETING ITS WORK AND IS ABOUT TO CLOSE UP SHOP,

IT’S A PECULIAR TURN OF EVENTS, I’LL GRANT YOU THAT. BUT THIS IS
WASHINGTON, AFTER ALL, WHERE, TO RECALL THE WORDS OF LITTLE BUTTERCUP
IN H.MS, PINAFORE...

“THINGS ARE RARELY WHAT THEY SEEM,
SKIMMED MILK MASQUERADES AS CREAM,
HIGH-LOWS PASS AS PATENT LEATHERS,
JACKDAWS STRUT IN PEACOCK’S FEATHERS...” AND SO ON,
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IRRESPECTIVE OF THE TIMING, YOUR DELIBERATIONS, THEREFORE. ARE
IMPORTANT,

I INTEND TO SEND THE FINAL REPORT OF THIS WORKSHOP TO THE
ATTORNEY GENERAL -- WHOSE MONEY, AFTER ALL, WE ARE SPENDING -- BUT I
WILL ALSO DISTRIBUTE IT TO

MY COLLEAGUES IN THE U.S, PUBLIC HEALTH SERVICE AND ELSEWHERE IN
THE DEPARTMENT OF HEALTH AND HUMAN SERVICES,

TO THE LEADERSHIP OF THE CUSTOMS SERVICE, THE F.B,1., AND THE
POSTAL SERVICE, WHO ARE ALSO CONCERNED WITH THIS ISSUE,

AND TO THE PUBLIC IN GENERAL, IN WHOSE NAME ALL THIS WORK IS BEING
DONE,
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THIS MEETING MAY BE CLOSED TO THE PUBLIC, BUT ITS RESULTS ARE
NOT,

NOW, ONE FINAL COMMENT,

A YEAR AGO, WHEN I TOLD THE ATTORNEY GENERAL'S COMMISSION THAT
1’D BE PLEASED TO HELP THEM IN THEIR WORK, SOME MEMBERS OF MY STAFF

WARNED ME THAT PORNOGRAPHY WAS A “NO-WIN” ISSUE...THAT I SHOULD
PROCEED WITH EXTREME CAUTION,..OR, BETTER YET. NOT PROCEED IN THIS

AREA AT ALL,

I BRUSHED ASIDE THAT ADVICE, I’M GLAD THAT 1 DID, ALTHOUGH TODAY
I’M INCLINED TO BE LESS CAVALIER ABOUT IT.
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OVER THE PAST SEVERAL MONTHS I’VE BEEN ROUNDLY CRITICIZED BY
LIBERALS WHO WARN OF THE THREAT TO OUR CIVIL LIBERTIES POSED BY THIS
WORKSHOP, ON THE OTHER HAND, I HAVE BEEN TAKEN TO TASK BY CONSERVA-
TIVES WHO WARN OF THE THREAT TO THE NATION’S MORAL FIBER POSED BY THIS
WORKSHOP,

BOTH GROUPS HAVE URGED ME TO CALL THE WHOLE THING OFF.

BOTH GROUPS ARE WRONG,

THIS IS A PUBLIC HEALTH MEETING AND 1 DON’T EXPECT US TO ARGUE
LAW ENFORCEMENT AND CIVIL LIBERTIES. BUT TO CANCEL THIS WORKSHOP AND
STIFLE THE DISCUSSION OF THE HEALTH ASPECTS OF PORNOGRAPHY WOULD BE,
IN MY OPINION, AN ARROGANT BREACH OF FAITH WITH EVERYONE HERE AND AN
ABRIDGEMENT, OF SORTS, OF YOUR RIGHT TO ADVISE THE GOVERNMENT ABOUT A
MATTER OF GREAT PERSONAL AND PROFESSIONAL INTEREST.
ll

SO I HAVE HEARD THE COMPLAINT OF THE LIBERALS, BUT I MUST REJECT
IT,

SIMILARLY, I HAVE BEEN WARNED BY SOME CONSERVATIVES THAT THIS
WORKSHOP WILL BE JUST ANOTHER FORUM FOR THOSE PEOPLE WHO WANT 10
DESTROY EVERY VESTIGE OF MORALITY IN OUR SOCIETY. BUT I EXPECT THAT
ALL OF US HERE THIS EVENING ARE DEEPLY CONCERNED ABOUT ANY HARMFUL
EFFECTS PORNOGRAPHY MAY HAVE UPON CERTAIN VULNERABLE GROUPS IN OUR
SOCIETY, ESPECIALLY YOUNG CHILDREN AND ADOLESCENTS. HENCE, IN THOSE
TERMS, I ANTICIPATE OUR DISCUSSIONS WILL BE PROFOUNDLY MORAL.

SO I HAVE HEARD THE COMPLAINT OF THE CONSERVATIVES, BUT I MUST
REJECT THEIRS, ALSO,

NOBODY SAID THIS WOULD BE A BED OF ROSES. BUT TODAY I COULD DO
WITH THE BENIGN THORNS OF A ROSE GARDEN, COMPARED TO THE BARBS I'VE
RECEIVED FROM THE LEFT AND THE RIGHT DURING THE PAST COUPLE OF MONTHS,
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BUT I’M NOT ASKING FOR YOUR SYMPATHY -- ALTHOUGH I WOULDN‘T TURN
IT AWAY, RATHER, I'M ASKING FOR YOUR VERY BEST THINKING BETWEEN NOW
AND TUESDAY AFTERNOON. WHEN WE SHOULD BE FINISHED WITH OUR WORK,

1 HAVE STEADFASTLY BELIEVED THAT, IN THE GENERAL DISCUSSION OF
PORNOGRAPHY THUS FAR, AMERICANS HAVE PAID SCANT ATTENTION TO THE
IMPORTANT EFFECTS PORNOGRAPHY MAY HAVE UPON THE PHYSICAL AND MENTAL
HEALTH OF OUR CITIZENS, PARTICULARLY UPON OUR CHILDREN.

THAT'S THE FUNDAMENTAL ISSUE WE’RE CONFRONTING IN THESE FEW DAYS
TOGETHER,

SO I MUST ASK YOU THE THREE KEY QUESTIONS OF THIS WORKSHOP:
LB

FIRST, WHAT DO WE KNOW WITH SOME DEGREE OF CERTAINTY ABOUT THE
EFFECTS OF PORNOGRAPHY UPON THE PHYSICAL AND MENTAL
HEALTH OF OUR PEOPLE, ESPECIALLY UPON YOUNG CHILDREN AND

ADOLESCENTS?

SECOND, WHAT KINDS OF THINGS DO WE STILL NEED TO KNOW...IN OTHER
WORDS, WHAT IS OUR RESEARCH AGENDA FOR THE FUTURE?

AND THIRD, AS PROFESSIONALS IN PUBLIC HEALTH AND MEDICINE, WHAT DO
WE THINK OUGHT TO BE DONE NEXT, EITHER BY OUR COLLEAGUES
IN RESEARCH AND CLINICAL PRACTICE OR BY OUR GOVERNMENT?

IF WE GIVE GOOD, THOUGHTFUL ANSWERS TO THESE THREE QUESTIONS, WE
WILL HAVE ACQUITTED OURSELVES WELL BEFORE OUR RESPECTIVE PROFESSIONS,
AND THE PUBLIC INTEREST WILL HAVE BEEN SERVED IN A TIMELY AND VITAL

MANNER,
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NOW, WITHOUT ANY MORE FANFARE, I WOULD LIKE TO TURN THE WORKSHOP
OVER TO MY FRIEND AND COLLEAGUE -- AND OUR FACILITATOR AND CHAIRPERSON
FOR THE REMAINDER OF OUR TIME TOGETHER -- DR. ALBERTO SERRANO.

THANK YOU,

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